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Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan
An open-label, prospective, multicenter study was conducted between October 2006 and March 2010 to assess the efficacy and safety of intravenous voriconazole (VRCZ) as empirical therapy for antibiotic-refractory febrile neutropenia in Japanese patients with hematological disorders. In addition, to f...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Japan
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857881/ https://www.ncbi.nlm.nih.gov/pubmed/23813092 http://dx.doi.org/10.1007/s10156-013-0634-5 |
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author | Koh, Hideo Hino, Masayuki Ohta, Kensuke Iino, Masaki Urase, Fumiaki Yamaguchi, Masaki Yamanouchi, Jun Usui, Noriko Yoshida, Minoru Tanimoto, Mitsune Ohyashiki, Kazuma Urabe, Akio Tamura, Kazuo Kanamaru, Akihisa Masaoka, Tohru |
author_facet | Koh, Hideo Hino, Masayuki Ohta, Kensuke Iino, Masaki Urase, Fumiaki Yamaguchi, Masaki Yamanouchi, Jun Usui, Noriko Yoshida, Minoru Tanimoto, Mitsune Ohyashiki, Kazuma Urabe, Akio Tamura, Kazuo Kanamaru, Akihisa Masaoka, Tohru |
author_sort | Koh, Hideo |
collection | PubMed |
description | An open-label, prospective, multicenter study was conducted between October 2006 and March 2010 to assess the efficacy and safety of intravenous voriconazole (VRCZ) as empirical therapy for antibiotic-refractory febrile neutropenia in Japanese patients with hematological disorders. In addition, to find the patient groups that may benefit from antifungal therapy, the definition of invasive fungal infection proposed by EORTC/MSG (2002) was assessed in this study. Plasma (1-3)-β-d-glucan and Aspergillus PCR in blood were also measured to improve the diagnostic accuracy. A total of 103 patients (median age, 59 years), including 25 undergoing induction chemotherapies and 19 allogeneic hematopoietic cell transplants, were evaluable. Sixty-nine percent of the patients achieved resolution of clinical symptoms and 31 % achieved treatment success, defined as fulfilling the previously described five-part composite endpoint. Although VRCZ was discontinued in 9.7 % of the patients because of adverse effects, all the patients recovered soon after discontinuation of VRCZ. The treatment success rate of VRCZ appeared to be higher in patients categorized as “not classified” compared with “possible invasive fungal disease” according to the EORTC/MSG criteria. Moreover, six “not classified” patients were positive for either plasma (1-3)-β-d-glucan (n = 5) or Aspergillus PCR in blood (n = 2). The present study demonstrates that empirical VRCZ therapy is safe and effective in Japanese patients. Additionally, (1-3)-β-d-glucan and Aspergillus PCR tests were expected to provide additional information on the diagnosis of invasive fungal infections. |
format | Online Article Text |
id | pubmed-3857881 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer Japan |
record_format | MEDLINE/PubMed |
spelling | pubmed-38578812013-12-11 Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan Koh, Hideo Hino, Masayuki Ohta, Kensuke Iino, Masaki Urase, Fumiaki Yamaguchi, Masaki Yamanouchi, Jun Usui, Noriko Yoshida, Minoru Tanimoto, Mitsune Ohyashiki, Kazuma Urabe, Akio Tamura, Kazuo Kanamaru, Akihisa Masaoka, Tohru J Infect Chemother Original Article An open-label, prospective, multicenter study was conducted between October 2006 and March 2010 to assess the efficacy and safety of intravenous voriconazole (VRCZ) as empirical therapy for antibiotic-refractory febrile neutropenia in Japanese patients with hematological disorders. In addition, to find the patient groups that may benefit from antifungal therapy, the definition of invasive fungal infection proposed by EORTC/MSG (2002) was assessed in this study. Plasma (1-3)-β-d-glucan and Aspergillus PCR in blood were also measured to improve the diagnostic accuracy. A total of 103 patients (median age, 59 years), including 25 undergoing induction chemotherapies and 19 allogeneic hematopoietic cell transplants, were evaluable. Sixty-nine percent of the patients achieved resolution of clinical symptoms and 31 % achieved treatment success, defined as fulfilling the previously described five-part composite endpoint. Although VRCZ was discontinued in 9.7 % of the patients because of adverse effects, all the patients recovered soon after discontinuation of VRCZ. The treatment success rate of VRCZ appeared to be higher in patients categorized as “not classified” compared with “possible invasive fungal disease” according to the EORTC/MSG criteria. Moreover, six “not classified” patients were positive for either plasma (1-3)-β-d-glucan (n = 5) or Aspergillus PCR in blood (n = 2). The present study demonstrates that empirical VRCZ therapy is safe and effective in Japanese patients. Additionally, (1-3)-β-d-glucan and Aspergillus PCR tests were expected to provide additional information on the diagnosis of invasive fungal infections. Springer Japan 2013-06-28 2013 /pmc/articles/PMC3857881/ /pubmed/23813092 http://dx.doi.org/10.1007/s10156-013-0634-5 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Koh, Hideo Hino, Masayuki Ohta, Kensuke Iino, Masaki Urase, Fumiaki Yamaguchi, Masaki Yamanouchi, Jun Usui, Noriko Yoshida, Minoru Tanimoto, Mitsune Ohyashiki, Kazuma Urabe, Akio Tamura, Kazuo Kanamaru, Akihisa Masaoka, Tohru Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title | Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title_full | Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title_fullStr | Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title_full_unstemmed | Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title_short | Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan |
title_sort | empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in japan |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857881/ https://www.ncbi.nlm.nih.gov/pubmed/23813092 http://dx.doi.org/10.1007/s10156-013-0634-5 |
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